Lymphoid and Myeloid Leukemias—Current Progress in Biology and Treatment

Dear Colleagues,

Leukemia is a neoplastic disease usually present in the blood, and one that originates from myeloid or lymphoid cells in the bone marrow or lymphoid tissue.  Leukemias can be divided into lymhoid and lymphoid forms, depending on the cells from which they originate, with both types being chronic or acute.

Acute myeloid leukemia (AML) is the most common common myloid leukemia in adults, with an annual incidence  of 4.3 per 100,000.  AML is characterized by the clonal expansion and differentiation arrest of myeloid precursor cells. A subtype of AML is acute promyelocytic leukemia (APL); it is characterized by an abnormal accumulation of  promyelocytes and the presence of t (15;17) (q22;q21) translocation as well as the PML-RAR-alpha fusion gene transcript.

Among the chronic forms, chronic myeloid leukemia (CML) is a BCR-ABL1-positive, myeloproliferative neoplasm with the Philadelphia chromosome/translocation t(9;22)(q34;q11.2). It is usually observed during or after middle age. Standard treatment for chronic-phase CML includes the tyrosine kinase inhibitors imatinib, dasatinib, nilotinib, bosutinib, and ponatinib. In contrast, chronic lymphocytic leukemia (CLL) predominantly affects older individuals; it is responsible for approximately 40% of all adult leukemias, wth an incidence of 3.5 cases per 100,000 inhabitants per year, and is the most common mature B-cell leukemia. In recent years, targeted drugs, including Bruton’s tyrosine kinase (BTK) inhibitors and BCL-2 inhibitors, have significantly improved survival for most patients.

Hairy cell leukemia (HCL) is a rare, indolent B-cell leukemia with an annual incidence of about 0.3 cases per 100,000. Its typical clinical presentation involves pancytopenia, splenomegaly, constitutional symptoms, and increased susceptibility to infection. Purine nucleoside analogs, cladribine, and pentostatin remain the drugs of choice in the treatment of classic HCL; however, new targeted drugs, including BRAF inhibitors, BTK inhibitors, and venetoclax, have recently been investigated.

Large granular lymphocytic leukemia (LGL) is a rare type of chronic lymphoid leukemia, comprising cytotoxic lymphocytes which can be immunophenotypically either T cell or NK cell-derived.  LGL constitutes 2-5% of all chronic lymphoproliferative diseases in Western countries. The most common clinical symptoms at presentation are pres neutropenia, anemia, and thrombocytopenia. Patients with LGL usually have an indolent course, with the cause of death often being secondary to other associated diseases.

Finally, acute lymphocytic leukemia (ALL) is the most common type of leukemia  in children. Although it typically demonstrates good prognosis and a strong chance for a cure in most patients, some subsets of patients, usually older ones, still suffer high relapse rates after chemotherapy or hematopoietic stem cell transplantation and an unsatisfactory cure rate. A better understanding of the etiology and discovery of novel targeted drugs, even for most leukemias, may help in yielding more consistent responses and better prognosis in these patients.

For this Special Issue of Cancers, we welcome original research and review articles that provide an overview of the most recent advances and future challenges for the diagnosis and treatment of lymphoid and myeloid leukemias.  

Prof. Dr. Ewa Robak
Prof. Dr. Tadeusz Robak
Guest Editors

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• acute myeloid leukemia
• promyelocytic leukemia
• myelomonocytic leukemia
• chronic lymphocytic leukemia
• hairy cell leukemia
• prolymphocytic leukemia
• large granular lymphocyte leukemia
• acute lymphoblastic leukemia